A comparison of the reliability of dynamic retinoscopy and subjective measurements of amplitude of accommodation

León, Alejandro; Medrano, Sandra; Rosenfield, Mark

doi:10.1111/j.1475-1313.2012.00891.x

Cited by 31 publications

(32 citation statements)

References 27 publications

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“…The mean AA results found in this study were similar to previous studies using the ML procedure at 40 cm[81718] and at 33 cm,[19] while the CORs determined in this study at either distance were generally smaller compared to previous reports.…”

Section: Discussionsupporting

confidence: 88%

Accommodative amplitude using the minus lens at different near distances

Momeni‐Moghaddam

Cesana

et al. 2017

Indian J Ophthalmol

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Purpose:The purpose of this study was to compare the mean findings and the repeatability of the minus lens (ML) amplitude of accommodation (AA) at 33 cm and 40 cm.Materials and Methods:AA was measured from the dominant eye of 120 fully corrected subjects using the ML procedure when viewing the target at both 33 and 40 cm. Each measurement was repeated between 24 and 48 hours after the first trial.Results:Mean AA when tested at 33 cm and 40 cm was 10.20 diopter (D) (standard deviation [SD] =1.24) and 8.85 D (SD = 1.23), respectively (P < 0.001). The limits of agreement of the measured amplitude calculated with taking into account of the replicates at 33 and 40 cm were − 0.19 (95% confidence interval [CI]: −0.34 to −0.04) and 2.53 (95% CI: 2.38 to 2.68), respectively. The repeatability of testing at the two distances 33 and 40 cm was ± 1.24 and ± 0.99, respectively. In addition, the retest reliability of measured amplitude using the intraclass correlation coefficient was 0.87 (95% CI: 0.789–0.920) at 33 cm and 0.91 (95% CI: 0.872–0.945) at 40 cm.Conclusion:There is no agreement in the obtained amplitude at the two measurement distances. Testing the ML AA at 40 cm may be superior given that a lower repeatability coefficient was observed. However, it is unclear whether the larger amplitude measured at 33 cm reflects a larger increase in accommodation (greater proximity effect) or a decrease in the ability to perceive the first slight sustained blur.

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Section: Discussionsupporting

confidence: 88%

Accommodative amplitude using the minus lens at different near distances

Momeni‐Moghaddam

Cesana

et al. 2017

Indian J Ophthalmol

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“…This difference could be attributed to the difference in the mean age of their subjects (19.7 years vs. 21.2 years in the present study). [7]…”

Section: Discussionmentioning

confidence: 99%

“…[3] The subjective techniques include the push-up (PU), push-down (PD) (also termed push-away), and minus lens (ML) methods. [4] The results of previous studies comparing these different methods[567891011121314151617] are shown in Table 1.…”

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confidence: 99%

Comparing measurement techniques of accommodative amplitudes

Momeni‐Moghaddam

Kundart

Askarizadeh

2014

Indian J Ophthalmol

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Aim and Background:This study was designed to compare four standard procedures, for determining the monocular accommodative amplitudes.Materials and Methods:Fifty-two students participated in this analytical-descriptive study. Accommodative amplitudes were measured using four common clinical techniques, namely: Push-up, push-down, minus lens, and modified push-up.Results:The highest amplitude was obtained using the push-up method (11.21 ± 1.85 D), while the minus lens technique gave the lowest finding (9.31 ± 1.61 D). A repeated-measures Analysis of Variance (ANOVA) showed a significant difference between these methods (P < 0.05), further analysis showed that this difference was only between the minus lens and other the three methods (the push-up (P < 0.001), the push-down (P < 0.001) and the modified push-up (P < 0.001)). The highest and the lowest mean difference was related to the push-up with the minus lens, and the push-down with the modified push-up, while the highest and the lowest 95% limits of agreement were related to the push-up with the modified push-up and the push-up with the push-down methods. There was almost a perfect agreement between the push-up and the push-down method, whereas, a poor agreement was present between the modified push-up and the minus lens technique, and a fair agreement existed between the other pairs.Conclusions:The quick and easy assessment of the amplitude using the push-up and the push-down methods compared to other methods, and the obtained perfect agreement between these two methods can further emphasize their use as a routine procedure in the clinic, especially if a combination of the two techniques is used to offset their slight over- and underestimation.

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“…Although this is a significant drawback in terms of the absolute measurements, whether or not an individual child wore their distance correction should not markedly affect the reproducibility of the measurements we gathered, and it is reproducibility which is the main point of interest here. Another drawback is that while the push-up method may be one of the most recommended and commonly used techniques to assess AA,19 several other subjective methods are available, including the modified push-up method,20 the push-down method (with/without modification21) and the minus-lens technique,21 although the usefulness of this latter method in children has been called into question 22. For adults these methods have been found to yield different values for AA and differences in repeatability 23 24.…”

Section: Discussionmentioning

confidence: 99%

“…Given the inherently subjective nature of measuring accommodation using any of the above-mentioned methods, and the particular difficulty this creates in children, assessment of accommodative function using more objective techniques21 26–28 would appear to hold promise. For example, dynamic retinoscopy has been used to examine the accuracy of accommodation among age groups that might be expected to have a reduced AA (eg, children with trisomy 2129).…”

Section: Discussionmentioning

confidence: 99%